what's in your case? optimizing content for clinical learning

What’s in Your Case?OPTIMIZING CONTENT FOR CLINICAL EDUCATION

Alexandra Howson MA CHCP PhD

a wee introductionTO THE CONTEXT OF CLINICAL EDUCATION

Lucey CR. JAMA 2013;173(17):1639-1643

IOM Framework

Foundational education

Graduate educationContinuing education

Clinical Learning Across a Continuum

Learning Paradigms Have Changed Too

Why Case-Based Learning?

Adult Learning

Andragogy

Cognitive Theory

Situated LearningCritical theory

Social Learning

Principles of Adult LearningSelf-directed

RelevantProblem-orientedEngaging

Feedback

The Anatomy of Cases

The advantages of the case-based method are the promotion of self-

directed learning, clinical reasoning, clinical problem-solving,

and decision-making by providing repeated experiences in class with a

collegial infrastructure and by focusing the student on the complexity of clinical care.

Richards PS, Inglehart MR. J Dent Educ . 2006 70(3):284–291

“”

Set well-defined learning objectives + outcomes measures

Establish a knowledge/competence baseline

Sequence tasks + decisions across ↑ levels of difficulty

Provide feedback

Principles of Case-Based Learning

Levels of Outcome

Participation

1 2Satisfactio

n

3Knowledge

4 5Performan

ce

6Patient Health

7Community Health

5Performan

ce

6Patient Health

Moore DE, et al. JCEHP. 2009;29(1):1-15

Competence

Knowledge

Competence

e.g. HCV treatment

On-site + tele-ECHO case-based clinics

Over 18 months, 280 enrolled in program + 46% started treatment

MEASURABLE OUTCOMESAligned with learning objectives

AUTHENTICComplex problems

CREDIBLEActivities aligned with real-world challenges

ACTIVE DISCOVERYMirrors clinical reasoning + allows safe failures

FEEDBACKCorrection + reinforcement

Components of Effective Cases

Compelling story

Supporting information

Unfolds over time

Relevant prompts

Case Characteristics

Case Examples

Live Program Case Sequence

Case introduction

Clinical informati

onARS

questionCorrect

answer + rationale

Case Introduction + Clinical Information

ARS Question

Correct answer + rationale

Online Case-Based Sequence

Case introduction Clinical information

Knowledge or

procedural question

FeedbackCorrect

answer + rationale

Expert commentaryVirtual patient commentaryCountersClinical outcome

Case Introduction

Knowledge-based question

Feedback

Rationale and reinforcement

Multiple choice questions

Active Discovery

Expert commentary

Feedback

Correct response

Correct response

Feedback

Open-ended question

Active Discovery

A More Complex CaseONLINE INTERACTIVE

MEASURABLE OUTCOMESAligned with learning objectives

CREDIBLEComplex problems

AUTHENTICActivities aligned with real-world challenges

ACTIVE DISCOVERYMirrors clinical reasoning + allows safe failures

FEEDBACKCorrection + reinforcement

Compelling story

Supporting information

Unfolds over time

Relevant prompts

Case introduction Clinical information

Knowledge or

procedural question

FeedbackCorrect

answer + rationale

Summary

The Benefits of CasesBuild competencies

Foster deep learning

Integrate different kinds of knowledge

Enhance motivation to learn

Model real-world applications

What’s in Your Case? Alexandra Howson MA CHCP PhD

alexhowson@thistleeditorial.com t: 415.374.9757